TiUnite implant surface – proven to perform

TiUnite is a unique implant surface that enhances osseointegration – even under the most challenging conditions including soft bone and immediate loading.3,11,12,14,15,16,18 TiUnite is a thickened, moderately rough titanium oxide layer with high crystallinity and a high phosphorus content.19

Predictable osseointegration with minimal failure rates

The TiUnite implant surface was first introduced on the Brånemark System in 2000. This shift from machined to TiUnite surface resulted in a clear decrease in early failures, especially in areas with poor bone density.1,2

Immediately load your implants

TiUnite also allows for immediate loading protocols to be used more frequently and with superior outcomes.3Additionally, implants with the TiUnite surface increase survival rates when used in revision surgeries.4

Short- and long-term success

TiUnite maintains implant stability immediately after placement with enhanced osseointegration and anchorage in surrounding bone.5,6,7 In the long term, it maintains marginal bone and soft tissue levels, maximizing functional endurance and esthetics.8,9,10

TiUnite is one of the most researched implant surfaces

TiUnite has been clinically documented in more than 275 publications on clinical studies and case series. In total, more than eleven million implants with TiUnite surface have been placed in patients across the world.

High stability in the critical healing phase

TiUnite maintains implant stability immediately after placement with enhanced osseointegration and anchorage in surrounding bone.5,6,7This is particularly important in regions with soft bone and/or high occlusal loads as well as for immediate loading protocols.

Clinical experience of over 14 years

Very few implant systems can offer a wealth of long-term data that matches that of the original Brånemark System. Clinical studies are available with up to eleven-year follow-up data.8,9,10

Proven longevity with 10-year clinical data

The first three long-term studies indicate that implants with TiUnite surface maintain marginal bone, both in partially and fully edentulous cases, with cumulative survival rates of 97.1–99.2% after ten and more years – even when placed in fresh extraction wounds and immediately loaded.8,9,10,20

Stable marginal bone levels over the long term

Implants with TiUnite surface demonstrate excellent crestal bone stability over the long term.8,9,10,13 In a study on TiUnite, for example, mid-term change between one and five years is on average 0.0 mm; and long-term change between one and ten years is -0.3 mm (see figure on the left).9

Other key findings

High performance under the most challenging conditions, including soft bone and immediate loading.3,11,12,14,15, 16, 18

There are several structural similarities between gingiva and peri-implant tissue which provide protection for the underlying soft tissues and alveolar bone.17

Platelet attraction

Platelet activation

The platelets begin to swell and form pseudopodia. By releasing adenosine diphosphate (ADP), they get sticky and clump together, closing the injured blood vessels at the wound edges to stop the bleeding.

Hemostasis

The newly formed fibrin matrix allows the blood to clot. Activated platelets become embedded in the matrix and release granules full of enzymes and growth factors needed for wound healing and bone formation.

Blood clot

Blood cells, activated platelets and fibrin form a blood clot that adheres to the moderately rough TiUnite surface. It is crucial for contact osteogenesis that the blood clot remains attached to the surface.

Provisional matrix

Neutrophils and, later, macrophages, remove the blood clot during the first two days of wound healing. Osteogenic cells stream to the TiUnite surface and migrate to the front of the forming bone. Here, they turn into osteoblasts.

Contact osteogenesis

Newly formed bone spreads over the osteoconductive TiUnite surface and forms a thin band of woven bone deposited directly on and along the surface. This thin bone layer will grow by further bone apposition and turn into lamellar bone.

Bone anchorage

Bone forming osteoblasts attach to the TiUnite surface and cover the orifices of the open pores. They start to secrete the collagen matrix of woven bone directly into the pores and move away from the surface. This forms the collagenous bone matrix which will eventually mineralize.

Osteoconductive surface for new bone formation

Newly formed bone crosses the gap between local bone and implant by distance osteogenesis. When the bone reaches the TiUnite surface, it spreads over it by contact osteogenesis, characterized by woven bone deposited directly on and along the surface.

Osseointegration

Transmitted and polarized light shows early (four weeks) and ongoing (six months) bone formation by contact osteogenesis and final osseointegration.

Grooves

Grooves added to the threads of the implant promote initial bone formation. Bone grows in a spiral-like fashion along the grooves before spreading laterally over the entire TiUnite surface.

Bone fragments

During drilling bone fragments are generated and accumulate in the osteotomy, especially in the apical region. In this area, they serve as nuclei for bone formation by guiding osteogenic cells through the wound and towards the TiUnite surface.

Prof. Bertil Friberg, Brånemark Clinic, Sweden

"The TiUnite surface has improved our results, especially in grafted bone and in bone of low density. It has, without question, significantly reduced our early failure rate as well."

Dr. Thomas Müller-Hotop, Germany

"Ever since the TiUnite surface became available, we have used it for all indications in our dental office. We see major benefits in advanced indications such as immediate implant placement, immediate loading and implant placement in soft bone conditions."

Dr. Javier Alández, Spain

"Recently, we have conducted a retrospective study using Immediate Function. Based on the results of a six-year follow-up, we can conclude that the Immediate Function protocol with TiUnite implants is predictable and we can expect a high success rate."

TiUnite - Nobel Biocare

Peri-implantitis is a frequent topic of discussion within the dental implant industry and understandably an area of concern for patients. It can be difficult to distinguish fact from fiction when it comes to implant surfaces and their relationship with peri-implantitis....

A newly published meta-analysis evaluating Nobel Biocare’s TiUnite implant surface (1) is believed to be the largest such evaluation of a single implant brand ever conducted. Here, the lead author Prof. Dr. Matthias Karl of Saarland University in Germany takes questions on the...

Following the introduction of the TiUnite surface in 2000, a clear decrease in early implant failures was observed—especially in areas with poor bone density. In retrospect, that launch can be seen as an important milestone on the journey towards routine Immediate Function.

2 Olsson M, Stenport V, Jemt T. Incidence of first implant failure. A retro-prospective study on 10 719 implant operations in 8 528 treated patients during a 28-years period of time at one specialist clinic. submitted 2014.